Plasma Depletion and Mirror Waves Ahead of Interplanetary Coronal Mass Ejections

We find that the sheath regions between fast interplanetary coronal mass ejections (ICMEs) and their preceding shocks are often characterized by plasma depletion and mirror wave structures, analogous to planetary magnetosheaths. A case study of these signatures in the sheath of a magnetic cloud (MC) shows that a plasma depletion layer (PDL) coincides with magnetic field draping around the MC. In the same event, we observe an enhanced thermal anisotropy and plasma beta as well as anti-correlated density and magnetic fluctuations which are signatures of mirror mode waves. We perform a superposed epoch analysis of ACE and Wind plasma and magnetic field data from different classes of ICMEs to illuminate the general properties of these regions. For MCs preceded by shocks, the sheaths have a PDL with an average duration of 6 hours (corresponding to a spatial span of about 0.07 AU) and a proton temperature anisotropy ${T_{\perp p}\over T_{\parallel p}}\simeq 1.2$ -1.3, and are marginally unstable to the mirror instability. For ICMEs with preceding shocks which are not MCs, plasma depletion and mirror waves are also present but at a reduced level. ICMEs without shocks are not associated with these features. The differences between the three ICME categories imply that these features depend on the ICME geometry and the extent of upstream solar wind compression by the ICMEs. We discuss the implications of these features for a variety of crucial physical processes including magnetic reconnection, formation of magnetic holes and energetic particle modulation in the solar wind.Comment: fully refereed, accepted for publication in J. Geophys. Re

A Rabbit Model Study to Determine the Efficacy of a Prototype Corneal Endothelium Protector during Cataract Surgery

Purpose. We evaluated the efficacy and safety of a mechanical device, the P-chute, in corneal endothelium preservation during phacoemulsification in a rabbit model. Methods. Twenty-four rabbits were randomly assigned into 2 groups. One eye of each rabbit underwent phacoemulsification that simulated the removal of a dense nucleus, with or without the P-chute. Serial slit-lamp examinations, anterior segment optical coherence tomography (ASOCT) scans, and specular microscopy were performed. Three rabbits from each group were sacrificed on postoperative days (PODs) 1, 5, 7, and 14. Histological analysis of the corneas was performed. Results. There was a trend towards lesser endothelial cell loss for the P-chute group at POD1 (4.9% versus 12.5%, p=0.53), POD5 (10.4% versus 12.2%, p=0.77), and POD7 (10.5% versus 17.2%, p=0.52). There was no significant difference in the corneal thickness (p=>0.05) between the 2 groups. The insertion of the device was challenging. The use of the P-chute only added an extra 15% to the surgical time. Conclusions. There was a trend towards better endothelium preservation with the P-chute even though the results were not statistically significant. We believe that the device could be useful in certain surgical situations. Further work is needed to improve the device insertion

Cardiovascular Outcomes in Acute Coronary Syndrome and Malnutrition: A Meta-Analysis of Nutritional Assessment Tools

Background: There is emerging evidence that malnutrition is associated with poor prognosis among patients with acute coronary syndrome (ACS). // Objectives: This study seeks to elucidate the prognostic impact of malnutrition in patients with ACS and provide a quantitative review of most commonly used nutritional assessment tools. // Methods: Medline and Embase were searched for studies reporting outcomes in patients with malnutrition and ACS. Nutritional screening tools of interest included the Prognostic Nutrition Index, Geriatric Nutritional Risk Index, and Controlling Nutritional Status. A comparative meta-analysis was used to estimate the risk of all-cause mortality and cardiovascular events based on the presence of malnutrition and stratified according to ACS type, ACS intervention, ethnicity, and income. // Results: Thirty studies comprising 37,303 patients with ACS were included, of whom 33.5% had malnutrition. In the population with malnutrition, the pooled mortality rate was 20.59% (95% CI: 14.95%-27.67%). Malnutrition was significantly associated with all-cause mortality risk after adjusting for confounders including age and left ventricular ejection fraction (adjusted HR: 2.66, 95% CI: 1.78-3.96, P = 0.004). There was excess mortality in the group with malnutrition regardless of ACS type (P = 0.132), ethnicity (P = 0.245), and income status (P = 0.058). Subgroup analysis demonstrated no statistically significant difference in mortality risk between individuals with and without malnutrition (P = 0.499) when using Controlling Nutritional Status (OR: 7.80, 95% CI: 2.17-28.07, P = 0.011), Geriatric Nutritional Risk Index (OR: 4.30, 95% CI: 2.78-6.66, P < 0.001), and Prognostic Nutrition Index (OR: 4.67, 95% CI: 2.38-9.17, P = 0.023). // Conclusions: Malnutrition was significantly associated with all-cause mortality risk following ACS, regardless of ACS type, ethnicity, and income status, underscoring the importance of screening and interventional strategies for patients with malnutrition

Solar Wind Turbulence and the Role of Ion Instabilities

International audienc

Preliminary Assessment of Celecoxib and Microdiode Pulse Laser Treatment of Diabetic Macular Edema

Purpose: Inflammation may play an important role in the pathogenesis of diabetic macular edema, a major cause of vision loss in persons with diabetes. The purpose of this study was to evaluate combined antiinflammatory therapy and laser approaches for treating patients with diabetic macular edema. Methods: In this prospective, factorial, randomized, multicenter trial, we compared cyclo-oxygenase-2 inhibitor (celecoxib) with placebo and diode grid laser with standard Early Treatment Diabetic Retinopathy Study focal laser treatment in 86 participants with diabetic macular edema. The primary outcome is change in visual acuity of ≥15 letters from baseline, and the secondary outcomes include a 50% reduction in the retinal thickening of diabetic macular edema measured by optical coherence tomography and a 50% reduction in leakage severity on fluorescein angiography. Results: Visual acuity and retinal thickening data from >2 years of follow-up did not show evidence of differences between the medical and laser treatments. However, participants assigned to the celecoxib group were more likely to have a reduction in fluorescein leakage when compared with the placebo group (odds ratio = 3.6; P < 0.01). Conclusion: This short-term study did not find large visual function benefits of treatment with celecoxib or diode laser compared with those of standard laser treatment. A suggestive effect of celecoxib in reducing fluorescein leakage was observed

The distribution of inverted repeat sequences in the Saccharomyces cerevisiae genome

Although a variety of possible functions have been proposed for inverted repeat sequences (IRs), it is not known which of them might occur in vivo. We investigate this question by assessing the distributions and properties of IRs in the Saccharomyces cerevisiae (SC) genome. Using the IRFinder algorithm we detect 100,514 IRs having copy length greater than 6 bp and spacer length less than 77 bp. To assess statistical significance we also determine the IR distributions in two types of randomization of the S. cerevisiae genome. We find that the S. cerevisiae genome is significantly enriched in IRs relative to random. The S. cerevisiae IRs are significantly longer and contain fewer imperfections than those from the randomized genomes, suggesting that processes to lengthen and/or correct errors in IRs may be operative in vivo. The S. cerevisiae IRs are highly clustered in intergenic regions, while their occurrence in coding sequences is consistent with random. Clustering is stronger in the 3′ flanks of genes than in their 5′ flanks. However, the S. cerevisiae genome is not enriched in those IRs that would extrude cruciforms, suggesting that this is not a common event. Various explanations for these results are considered

B cell–intrinsic signaling through IL-21 receptor and STAT3 is required for establishing long-lived antibody responses in humans

Engagement of cytokine receptors by specific ligands activate Janus kinase–signal transducer and activator of transcription (STAT) signaling pathways. The exact roles of STATs in human lymphocyte behavior remain incompletely defined. Interleukin (IL)-21 activates STAT1 and STAT3 and has emerged as a potent regulator of B cell differentiation. We have studied patients with inactivating mutations in STAT1 or STAT3 to dissect their contribution to B cell function in vivo and in response to IL-21 in vitro. STAT3 mutations dramatically reduced the number of functional, antigen (Ag)-specific memory B cells and abolished the ability of IL-21 to induce naive B cells to differentiate into plasma cells (PCs). This resulted from impaired activation of the molecular machinery required for PC generation. In contrast, STAT1 deficiency had no effect on memory B cell formation in vivo or IL-21–induced immunoglobulin secretion in vitro. Thus, STAT3 plays a critical role in generating effector B cells from naive precursors in humans. STAT3-activating cytokines such as IL-21 thus underpin Ag-specific humoral immune responses and provide a mechanism for the functional antibody deficit in STAT3-deficient patients

Mediator Acts Upstream of the Transcriptional Activator Gal4

We show that Mediator, a protein originally isolated on the basis of its ability to respond to transcriptional activators, and thought to be regulated by an activator, can also be the master that controls the activator

The EBLM Project VI. The mass and radius of five low-mass stars in F+M binaries discovered by the WASP survey

peer reviewedSome M-dwarfs around F-/G-type stars have been measured to be hotter and larger than predicted by stellar evolution models. Inconsistencies between observations and models need addressing with more mass, radius and luminosity measurements of low-mass stars to test and refine evolutionary models. Our aim is to measure the masses, radii and ages of the stars in five low-mass eclipsing binary systems discovered by the WASP survey. We use WASP photometry to establish eclipse-time ephemerides and to obtain initial estimates for the transit depth and width. Radial velocity measurements were simultaneously fitted with follow-up photometry to find the best-fitting orbital solution. This solution was combined with measurements of atmospheric parameters to interpolate evolutionary models and estimate the mass of the primary star, and the mass and radius of the M-dwarf companion. We assess how the best fitting orbital solution changes if an alternative limb- darkening law is used and quantify the systematic effects of unresolved companions. We also gauge how the best-fitting evolutionary model changes if different values are used for the mixing length parameter and helium enhancement. We report the mass and radius of five M-dwarfs and find little evidence of inflation with respect to evolutionary models. The primary stars in two systems are near the ``blue hook'' stage of their post sequence evolution, resulting in two possible solutions for mass and age. We find that choices in helium enhancement and mixing- length parameter can introduce an additional 3-5\,\% uncertainty in measured M-dwarf mass. Unresolved companions can introduce an additional 3-8\% uncertainty in the radius of an M-dwarf, while the choice of limb- darkening law can introduce up to an additional 2\% uncertainty

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years